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Percutaneous Cholecystostomy
Introduction
Surgical (open or laparoscopic) cholecystectomy or removal of gallbladder is the usual treatment for acute cholecystitis.
The operative risk is very high in patients with poor medical or genera condition
Percutaneous cholecystostomy provides an alternative.
The objective is to drain out the infected material or pus from the gall bladder in order to delay or obviate the surgical operation.
Cholecystostomy is performed under imaging guidance by radiologists with special training in interventional radiology.
The technical success rate of percutaneous cholecystostomy is high, usually over 90%
In 60-90% of patients, the clinical condition would improve.
Some patients (10-85%) would need an operative cholecystectomy at a later stage.
Procedur
It is performed under local anaesthesia, and it takes approximately an hour.
A needle is inserted into the gallbladder under ultrasound guidance. The same needle puncture site is serially dilated and finally a larger bore soft drainage catheter is placed into the gallbladder.
The catheter may be either a self-retaining catheter, or it may be sutured in place, and be connected to a plastic bag.
You would be monitored for vital sign (blood pressure and pulse rate) after the procedure.
The catheter will removed after at least 3-4 weeks or during cholecystectomy later.
Potential Complications
Right shoulder pain due to diaphragmatic irritation - < 34%.
Chills and Rigors – <17%.
Transient bile leakage or haemorrhage - <15%.
Bile peritonitis due to bile leakage – rare.
Procedure related mortality is rare.
Most patients who require cholecystostomy have generally poor medica condition. Overall mortality rate during hospitalization was reported to be up to 36%, although most are not procedure related.
The overall adverse reactions related to iodine-based contrast medium is below 0.7%. The mortality due to reaction to non-ionic contrast medium is below 1 in 250000.
Disclaime

This leaflet has been prepared by the Hong Kong Society of Interventional Radiology.

This leaflet is intended as general information only. Nothing in this leaflet should be construed as the giving of advice or the making of a recommendation and it should not be relied on as the basis for any decision or action. It is not definitive and the Hong Kong Society of Interventional Radiology Limited does not accept any legal liability arising from its use. We aim to make the information as up-to-date and accurate as possible, but please be warned that it is always subject to change as medical science is ever-changing with new research and technology emerging. Please therefore always check specific advice on the procedure or any concern you may have with your doctor.

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